This is most likely due to the heterogeneity of the subjects, vitamin D doses and environmental factors. However, the role of vitamin D in muscle pathologies is not clear and research has provided conflicting results. The most positive results were found in subjects with severe vitamin D deficiency and in patients avoiding high doses of vitamin D. In some observational and uncontrolled treatment studies, vitamin D supplementation led to a reduction of proximal myopathy and muscle pain. Generally, Vitamin D plasma concentration is significantly lower in participants with osteoporosis and muscle deterioration. This can lead not only to an increased risk of falls and fractures, but is also one of the main causes of frailty syndrome in the aging population. These consequences are related to a higher risk of adverse outcomes, such as fracture, physical disability, a poor quality of life and death. Sarcopenia is one of the musculoskeletal consequences of hypovitaminosis D. Geriatric giants, such as sarcopenia (progressive and generalized loss of skeletal muscle mass and strength) or cognitive decline, strongly influence elderly patients. This is a typical example of the situation where a lack of “hard evidence” is not synonymous with the possible lack of adverse effects. The phenomenon of drugs and vitamin D interactions is observed first and foremost in patients with comorbidity. The known factors affecting vitamin D metabolism interfere with cytochrome CYP3A4 activity. Therefore, all factors interfering with individual metabolic stages may affect 25-hydroxyvitamin D plasma concentration. Vitamin D status in geriatric population is an effect of joint interaction of all vitamin D metabolic pathways, aging processes and multimorbidity. In this group, low vitamin D plasma concentration is related to osteoporosis, osteomalacia, sarcopenia and myalgia. Vitamin D deficiency is common in elderly people, especially in patients with comorbidity and polypharmcy.

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